Stroke Risk Basic Prediction, AIH- American Intelligent Health

Please answer the following questions:

Name *

First name will work fine.

Gender *

Female

Male

Age *

Weight (lbs) *

Please round to nearest whole number.

Do you currently smoke? *

No, I have never smoked.

No, I have already quit.

Yes, I currently smoke.

How many alcoholic drinks do you usually have per day? *

Zero

1 to 2

More than 2

Have you ever been diagnosed with stroke? *

No

Yes

Have any of your family members been diagnosed with stroke? *

No

Yes

How often do you usually exercise (per week)? *

Zero

Once a week

2 to 3 times a week

4 or more times a week

Blood Pressure- Systolic (Upper Number) *

Blood Pressure- Diastolic (Lower Number) *

Are you currently diagnosed with diabetes? *

No

Yes